Access to reproductive healthcare still elusive, even in blue states like New York

Ongoing disparities in abortion rates reveal the structural impact of racism and poverty

By Katie McDonough
March 4, 2014 8:54PM (UTC)
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The assault on reproductive rights may at times seem like a crisis that is unique to states like Texas and North Dakota, but longstanding disparities in access to reproductive healthcare in traditionally "blue" states like New York continue to compromise women's health and bodily autonomy.

While the national abortion rate is the lowest its been since before Roe v. Wade, reliable access to reproductive healthcare remains elusive for many women and reproductive rights gains are not evenly felt by all. As Erin Billups at NY1 points out, higher abortion rates, particularly among black women, point to broader health disparities in reproductive healthcare and educational resources that are playing out across the country.


"The difference by race, ethnicity and by poverty has been true for many years," New York City Assistant Health Commissioner Dr. Deborah Kaplan, told NY1. "The underlying powerful structural factors around poverty, racism, gender discrimination affect every aspect of health, and abortion is no different."

Access to information is also a crucial issue. "Often, in low-income communities or in communities of color, there's less availability of information of sex education, of the kinds of resources you need to make choices about your sexual behavior and using contraception," Kaplan noted.

New York state does not have any of the abortion restrictions that are currently wrecking havoc on women's access to healthcare elsewhere in the country, but, as ongoing disparities in New York show, TRAP laws aren't the only threat to reproductive justice right now.


These heath disparities are also, of course, not only playing out in New York. As Eyal Press at the New Yorker recently noted, the abortion rate is going down nationally -- but only for some women.

[T]he over-all abortion rate fell by eight per cent between 2000 and 2008 but rose among poor women by eighteen per cent. Last December, another Guttmacher Institute study revealed that, during this same eight-year period, the rate of unintended pregnancies was more than five times higher among poor women than among women whose income was at least twice the federal poverty level. The same report found that significant ethnic and racial differences existed even when controlling for income, with the rate of unintended pregnancies among minority women more than twice the rate among white women.

Low-income women tend to have less access to the most reliable forms of birth control -- in particular, long-acting intrauterine devices (I.U.D.s), which are extremely effective, and which the new Guttmacher study touted as a potential factor behind the recent decline in the over-all abortion rate.

At issue here: cost and access, experts say.

“We know that cost is a major factor in a woman’s ability to choose and access a method of contraception that works best for her, and behind the cost is access to health-insurance coverage,” Kinsey Hasstedt, a public-policy associate at the Guttmacher Institute, told the New Yorker.




Katie McDonough

Katie McDonough is Salon's politics writer, focusing on gender, sexuality and reproductive justice. Follow her on Twitter @kmcdonovgh or email her at

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